Healthcare Provider Details

I. General information

NPI: 1609216308
Provider Name (Legal Business Name): DENNIS TRAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2013
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 S GREEN BAY RD
MOUNT PLEASANT WI
53406-4402
US

IV. Provider business mailing address

1919 E HILLCREST AVE
MILWAUKEE WI
53207-2929
US

V. Phone/Fax

Practice location:
  • Phone: 262-223-0280
  • Fax:
Mailing address:
  • Phone: 323-841-4528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDTRAN247
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: